Physicians, hospitals slowly expand e-health records

Physicians and hospitals are adopting electronic health records very slowly, about 3 percent more than last year, the Health and Human Services Department determined in a report released Wednesday.

About 25 percent of physicians use some form of electronic health record, but only one in 10 doctors practice with a fully operational system, said the report that measured the adoption of health IT. Only five percent of the 6,000 U.S. hospitals use computerized order entry, a component of electronic health records for electronic prescribing or electronic ordering of lab tests.

The Office of the Coordinator for Health IT contracted the study with the Massachusetts General Hospital/Harvard School of Public Health and George Washington University. It is a joint project with the Robert Wood Johnson Foundation.

Other organizations evaluate the extent of adoption, but the national coordinator's office in the Health and Human Services Department sought a consistent way to measure health IT usage to provide a benchmark on which to assess annual progress and to standardize definitions and terminology, said Karen Bell, director of the Office of HIT Adoption in the national coordinator's office.

'The bottom line is that it is the line in the sand that we are starting from,' she said at a briefing releasing the report.

Equipped with a baseline of adoption, HHS will be able to gauge the effectiveness of policies and, as a result, make revisions or recommendations where necessary, she said.

'As we put new policies in place, new technologies come to bear, new certification processes are implemented, [and] we will be looking at health care policies that will guide us in what to do over the next several years. It's really a tool to guide us in our decision-making,' Bell said.

HHS will share the data with the electronic health records working group in the public/private American Health Information Community advisory group to assist it in developing recommendations to accelerate adoption.

'We know there are issues around reimbursement, medical [and] legal concerns, technology ' not only are systems interoperable but are systems usable ' and cultural issues. Without recommendations to address these, we are not going to be able to move the adoption agenda forward in time to meet the president's goal for electronic health records for most Americans by 2014,' she said.

A fully operational electronic health system collects patient information, displays test results, allows providers to enter medical orders and prescriptions, and helps doctors make treatment decisions, said David Blumenthal, director of the Institute for Health Policy at Massachusetts General Hospital/Partners.

The report shows that EHR adoption rates remain very low due to multiple financial, technical and legal barriers.

'We are pitifully behind where we should be. We must find ways to get more physicians to embrace this technology if we are to make major strides in improving health care quality,' he said.

Based on other data, the researchers estimate that providers increased adoption by 3 percent from last year. At that rate, 60 percent to 80 percent of Americans will have e-health records by 2014, unless there is a tipping point phenomenon that accelerates adoption, Blumenthal said.

'Electronic health records are an important aspect of quality health care, because they let physicians have the right information to make the right decisions at the right time,' said John Lumpkin, senior vice president of the health care group at the foundation and former chairman of HHS' National Committee on Vital and Health Statistics.

Data showed that e-health records were used more in cities more than rural areas, more with reimbursed physicians than those who treat vulnerable, poor and Medicaid patients, and more in large practices than one- or two-physician offices. More than half of all U.S. physicians practice solo or in very small practices, the report said.

Overall, adoption depends on the effects of financial incentives and barriers; laws and regulations; the state of the technology and organizational influences; and how integrated a health care system is, the report said.

About the Author

Mary Mosquera is a reporter for Federal Computer Week.

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